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OIG urges CMS to strengthen safeguards for virtual check-in, e-visit payments

Wed, 04/29/2026
Revenue Integrity Insider
Billing and Claims, News, Monitoring and Audits, Coding and Documentation

The Office of Inspector General (OIG) recently conducted an audit to identify potential vulnerabilities in the Medicare program that could be contributing to improper payments for virtual check-in and e-visit services. 

A modern, integrated approach to revenue integrity

Wed, 04/29/2026
Revenue Integrity Insider
Policies and Procedures, Revenue Integrity, Program Management, Denials and Appeals, Compliance, Coding and Documentation

Gain insights into how healthcare organizations can modernize the mid-revenue cycle by integrating AI-driven insights, interdepartmental audit programs, and targeted provider education across inpatient, outpatient, and professional settings.

A closer look at CMS’ proposed CJR-X model

Wed, 04/22/2026
Revenue Integrity Insider
Reimbursement and Payment Methodologies, Billing and Claims, News

Learn more about CMS' plans to launch a nationwide expansion of its Comprehensive Care for Joint Replacement (CJR) model.

Defining charge reconciliation roles

Fri, 04/17/2026
Leadership Council Insider
Policies and Procedures, Revenue Integrity, Program Management, Chargemaster and Charge Capture

In theory, charge-generating departments own charge reconciliation, usually with some level of support from revenue integrity.

2027 IPPS proposed rule: Payment updates, expanded CJR model

Wed, 04/15/2026
Revenue Integrity Insider
Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, News, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

CMS is weighing an expansion of the Comprehensive Care for Joint Replacement (CJR) model as well as cuts to disproportionate share hospital (DSH) payments, according to the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule. 

Get an insider’s look at the 2026 Revenue Integrity Symposium

Wed, 04/15/2026
Revenue Integrity Insider
Revenue Integrity, News

On May 13, 1-130 p.m. Eastern, get a sneak peek at what's in store for you at the 2026 Revenue Integrity Symposium (RIS), to be held September 24-25 in Savannah, Georgia!

CMS changes course in CY 2027 MA and Part D rate announcement

Wed, 04/08/2026
Revenue Integrity Insider
Revenue Integrity, Reimbursement and Payment Methodologies, News, Coding and Documentation

CMS recently issued the calendar year (CY) 2027 Medicare Advantage (MA) and Part D rate announcement, which outlines upcoming changes to payment rates, risk adjustment policies, and more. 

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NAHRI Forum
Wed, 07/12/2017 - 13:31
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